Wagner, David A
Wagner, David A is an sole proprietor health care provider with primary practice located at 3285 State Route 257 , Seneca PA 16346-2529. He recently has 6 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Wagner, David A can be contacted via phone (814) 677-6636.Contact Information
Primary practice address
3285 State Route 257
Seneca PA 16346-2529
Phone: (814) 677-6636
Fax: (814) 677-9562
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OEG000125 | Pennsylvania |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OEG000125 | Pennsylvania |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | OEG000125 | Pennsylvania |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | OEG000125 | Pennsylvania |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | OEG000125 | Pennsylvania |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | OEG000125 | Pennsylvania |
Profile Details
| NPI number | 1295754778 |
|---|---|
| LBN Legal business name | Wagner, David A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Jul 25th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295754778 | NPPES |
| Pennsylvania | MEDICAID | 0018040170003 |
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